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Treatment. In general, strabismus can be approached and treated with a variety of procedures. Depending on the individual case, treatment options include: Correction of refractive errors by glasses; Prism therapy (if tolerated, to manage diplopia) Vision Therapy; Patching (mainly to manage amblyopia in children and diplopia in adults)
Esotropias measuring more than 15 prism diopters (PD) and exotropias more than 20 PD that have not responded to refractive correction can be considered candidates for surgery. Techniques Disinserting the medial rectus muscle. The goal of strabismus surgery is to correct misalignment of the eyes.
Treatment. Congenital fourth cranial nerve palsy can be treated with strabismus surgery, where muscle attachment sites on the globe are modified to realign the eyes. Some eye doctors prefer conservative or no management of congenital fourth nerve palsy.
Cyclotropia cannot be corrected with prism spectacles in the way other eye position disorders are corrected. (Nonetheless two Dove prisms can be employed to rotate the visual field in experimental settings.) For cyclodeviations above 5 degrees, surgery has normally been recommended.
Treatment depends on the type of strabismus and the underlying cause. This may include the use of glasses and possibly surgery. Some types benefit from early surgery. Strabismus occurs in about 2% of children. The term comes from the Ancient Greek word στραβισμός (strabismós), meaning 'a squinting'.
The prism cover test (PCT) is an objective measurement and the gold standard in measuring strabismus, i.e. ocular misalignment, or a deviation of the eye. It is used by ophthalmologists and orthoptists in order to measure the vertical and horizontal deviation and includes both manifest and latent components. [1]
Prism correction is measured in prism dioptres. A prescription that specifies prism correction will also specify the "base". The base is the thickest part of the lens and is opposite from the apex. Light will be bent towards the base and the image will be shifted towards the apex.
Other options for strabismus management are vision therapy and occlusion therapy, corrective glasses (or contact lenses) and prism glasses, and strabismus surgery. The effects that are due only to the toxin itself (including the side effects) generally wear off within 3 to 4 months.
The best treatment option to correct hypermetropia due to aphakia is IOL implantation. Other common types of refractive errors are near-sightedness, astigmatism, and presbyopia.
Drug treatment vs surgery. With surgery, results are seen in a few days. After bupivacaine injection the muscle is inactivated by the drug's anesthetic effect for a day, and weakened by myofiber destruction for a week or so, after which regeneration and hypertrophy over 2–3 weeks gradually achieves the corrected alignment.